The participating cardiologists and cardiovascular surgeons from Mayo Clinic will work with the other Bypass Angioplasty Revascularization Investigation (BARI) members and NHLBI staff in a multicenter trial that will test in a prospective randomized study if percutaneous transluminal coronary angioplasty (PTCA) is associated with similar relief of angina pectoris as coronary artery bypass graft surgery (CABGS) in patients with multivessel coronary artery disease without an increased risk of death or myocardial infarction and is performed with long-term lower socioeconomic cost. This trial will also test if, in comparable patients with multivessel coronary artery disease, PTCA (even with less complete revascularization) is equal to CABGS in maintaining survival and protecting against disabling angina pectoris and myocardial infarction over a ten year follow-up. Even if PTCA is proven to be a comparable alternative revascularization procedure only for a minority of patients with ischemic heart disease who are now receiving coronary artery bypass graft surgery, potential for health care cost containment could be great.